1
|
Cheng KJG, Santos-Lozada AR. Mental and physical health among 'sandwich' generation working-age adults in the United States: Not all sandwiches are made equal. SSM Popul Health 2024; 26:101650. [PMID: 38516528 PMCID: PMC10950688 DOI: 10.1016/j.ssmph.2024.101650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/25/2024] [Accepted: 03/02/2024] [Indexed: 03/23/2024] Open
Abstract
Objective This research examined mental and physical health differences by (1) potential upward and downward care recipients and (2) heterogenous time and money transfer arrangements among working-age adults aged 35-64 in the U.S. who are considered to belong to the 'sandwich generation'. Methods Data for this study came from the Panel Study of Income Dynamics 2013 Family File and Rosters and Transfers module (n = 4609). For the second study objective, we restricted the analytic sample to individuals with at least one living parent/parent-in-law and at least one child (n = 2228). We varied the sandwich generation experience by whether upward (i.e., to parent), downward (i.e., to children), or transfers at both directions occurred. We then fit a series of logistic regression models to study psychological distress and self-rated health status differences among various classifications of sandwich generation, controlling for basic sociodemographic factors and living arrangements. For both samples, we ran separate models for those without underaged coresident children. Results Compared to respondents without potential care recipients, sandwiched individuals do not differ concerning severe psychological distress or poor/fair health. Conditional on being sandwiched between parents/parents-in-law and adult children, providers of both upward and downward time transfers have almost twice the odds of having severe psychological distress while money providers to parents/parents-in-law have about 1.6 times higher odds of reporting poor/fair health status. Conclusion This study dispels the notion that being part of the sandwich generation is automatically deleterious to mental and physical health. Rather, it is the provision of certain transfers whilst being sandwiched that is associated with worse health outcomes.
Collapse
Affiliation(s)
- Kent Jason Go Cheng
- Center for Healthy Aging, College of Health and Human Development, The Pennsylvania State University, USA
| | - Alexis Rául Santos-Lozada
- Center for Healthy Aging, College of Health and Human Development, The Pennsylvania State University, USA
- Department of Human Development and Family Science, College of Health and Human Development, The Pennsylvania State University, USA
| |
Collapse
|
2
|
Luo J, Li B, Li J, Ren Z. Examining the impact of Co-residence with a daughter-in-law on older adult health in China: Evidence from a frailty index-based study. SSM Popul Health 2024; 26:101649. [PMID: 38516530 PMCID: PMC10955668 DOI: 10.1016/j.ssmph.2024.101649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/28/2024] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
Background The increasing geriatric population and variation in the disease spectrum among older adults in China contribute to a growing demand for more aged adult care in Chinese society. Relevant studies have shown that living arrangements with various family members have variable impacts on the older adult's health. This study employs the Frailty Index as a unified measurement standard to assess the overall health levels, integrating the specific "in-law relationships" into the research on living arrangements and the health of older adults. Methods This study used data from the China Longitudinal Aging Social Survey 2016-2018. OLS and Quantile Regression were used to investigate the in-law relationship on older adult health and whether this impact is homogeneous across older individuals with varying infirmity levels. The study used a lag model and propensity score matching to compensate for potential endogeneity concerns. Results The study found that residing with a daughter-in-law (20.22%) had a significant positive correlation with the frailty index (β=0.0088, P<0.001), indicating that the relationship between parents-in-law and daughters-in-law can influence the health of the older adult. This impact is nonlinear and non-homogeneous for older adult people with various levels of frailty, exhibiting an approximately decreasing and then increasing U-shaped distribution, which denotes that older adult people with different health conditions have distinct demands for intergenerational care. In addition, this impact varies among older adult groups of disparate genders, urban and rural areas, and age groups. Conclusion This study investigates the impact of "in-law relationships" within living arrangements on the health of older adults. It shows that co-residing with a daughter-in-law has adverse effects on the health of older adults. Therefore, the study suggests that when the health and economic conditions of the elderly permit, a "live-near-but-not-with" living arrangement with their children can be considered.
Collapse
Affiliation(s)
- Juan Luo
- School of Management, Shanghai University of Engineering Science, 333 Longteng Road, 201620, Shanghai, China
| | - Ben Li
- School of Management, Shanghai University of Engineering Science, 333 Longteng Road, 201620, Shanghai, China
| | - Jiarong Li
- School of Management, Shanghai University of Engineering Science, 333 Longteng Road, 201620, Shanghai, China
| | - Zhenpeng Ren
- School of Management, Shanghai University of Engineering Science, 333 Longteng Road, 201620, Shanghai, China
| |
Collapse
|
3
|
Lowers J, Datcher I, Kavalieratos D, Hepburn K, Perkins MM. Proactive Care-Seeking Strategies Among Adults Aging Solo With Early Dementia: A Qualitative Study. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae020. [PMID: 38375541 DOI: 10.1093/geronb/gbae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES People living with dementia need increasing care over time, but 1 in 3 adults with cognitive impairment lives alone. The goal of this study was to explore the self-identified strengths and resources for future care needs of adults aging solo with early dementia. METHODS Semistructured interviews with 15 adults not living with a partner and with no children in the same state, who self-identified as having early dementia or mild cognitive impairment; hybrid inductive/deductive reflexive thematic analysis using a successful aging framework. RESULTS Participants placed a high value on maintaining independence and expressed concerns about preserving selfhood and becoming a burden to others. These values influenced how participants appraised financial and social resources available to address future care needs and strategies to preempt or respond to needs such as transportation, help with finances, or activities of daily living. DISCUSSION Adults without close family are heterogeneous and have variable resources available to address care needs associated with dementia progression. Common values of retaining independence and minimizing burden to others may be helpful in motivating adults aging solo to undertake planning and help-seeking early.
Collapse
Affiliation(s)
- Jane Lowers
- Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, USA
| | - Ivree Datcher
- School of Public Health, University of Alabama-Birmingham, Birmingham, Alabama, USA
| | - Dio Kavalieratos
- Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, USA
| | - Ken Hepburn
- Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Molly M Perkins
- Department of Geriatrics, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
4
|
Shastri VG, Erney EJ. Psychosocial and Financial Issues Affecting LGBTQ+ Older Adults. Clin Geriatr Med 2024; 40:309-320. [PMID: 38521601 DOI: 10.1016/j.cger.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
Isolation, financial insecurity, incomplete advance care planning, and lack of safe/affordable/inclusive long-term care are challenges magnified in gender and sexual minorities. LGBTQIA+ older adults are disproportionately more likely to live alone and experience financial poverty and social isolation. LGBTQIA+ adults suffering from cognitive impairment are an especially defenseless population due to their lack of social connection and potential lack of financial resources and advance care planning.
Collapse
Affiliation(s)
- Vinita Gidvani Shastri
- GRECC, VA Palo Alto Health Care System, Stanford School of Medicine, 3801 Miranda Avenue (182b), Palo Alto, CA 94304, USA.
| | - Erica Joy Erney
- The Permanente Medical Group, Kaiser Permanente Santa Clara Medical Center, 710 Lawrence Expressway, Dept 440 (MOB), Santa Clara, CA 95051, USA
| |
Collapse
|
5
|
Wylie MJ, Boerner K, Miller EA, Kim K, Burr JA. Type of Home Care-Informal Versus At Least Some Formal-Matters for Recipients' Perceived Control. Gerontologist 2024; 64:gnad127. [PMID: 37772745 DOI: 10.1093/geront/gnad127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Perceived control is an important psychological resource for middle-aged and older adults. Aging in place may help foster feelings of control, yet many community-dwelling older adults must rely on others-whether family, friends, or professionals-for physical assistance. This study investigated how receiving home care from different sources was associated with two facets of perceived control (mastery and perceived constraints) among adults with varying levels of physical disability. RESEARCH DESIGN AND METHODS Data were drawn from the 2012 and 2014 waves of the Health and Retirement Study. Community-dwelling adults aged 50 years and older receiving help for at least one activity of daily living (ADL) impairment (N = 884) reported their relationship to each respective caregiver (formal professional and/or informal family or friend), level of ADL impairment, and ratings of perceived control. Ordinary least squares regression was used to examine the association between type of support and perceived control, as well as the moderating effect of physical disability on that relationship. RESULTS Compared to receipt of informal support alone, receiving a combination of formal and informal support was related to perceptions of greater control over one's life, but only in terms of mastery. The level of one's ADL impairment did not have a moderating effect on the relationship between support type and perceived control. DISCUSSION AND IMPLICATIONS Findings suggested that the type of instrumental support adults receive in their home has implications for specific facets of perceived control. These findings can help inform home care program development.
Collapse
Affiliation(s)
- Molly J Wylie
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Kathrin Boerner
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Edward Alan Miller
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Kyungmin Kim
- Department of Child Development and Family Studies, College of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | - Jeffrey A Burr
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, USA
| |
Collapse
|
6
|
Quiñones MM, Sörensen S, Hepburn K, Capellan J, Heffner KL. Community-Engaged Research With Latino Dementia Caregivers: Overcoming Challenges in Community Advisory Board Development. Gerontologist 2024; 64:gnad144. [PMID: 37878811 PMCID: PMC11020250 DOI: 10.1093/geront/gnad144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Latinos caring for a person with Alzheimer's disease and related dementias (ADRD) have the highest prevalence of caregiving. Yet, they are less likely to benefit from evidence-based interventions given their continued underrepresentation in ADRD-related research. Community advisory boards (CABs) have the potential to address barriers to research for underrepresented communities; however, there are complexities to establishing and sustaining CABs. This article describes how our work addressed challenges in CABs related to unbalanced power relations, language barriers, the value of time, and low research knowledge and health literacy. RESEARCH DESIGN AND METHODS Nine Latino CAB members, including older Latino caregivers, were trained in a comprehensive program designed to increase knowledge about health research methods and ethics, cognitive health, and cultural adaptation methods. Members completed pre- and post-training measures of Alzheimer's disease knowledge, attitudes, and beliefs toward research, and a satisfaction survey. RESULTS Results from the satisfaction questionnaire indicated that the program was well received. CAB members increased their knowledge regarding the management of behavioral and psychological symptoms of dementia and dementia-associated risk factors and treatment. Positive changes in members' attitudes toward research included increased willingness to participate in trials and subject protection measures. DISCUSSION AND IMPLICATIONS Formalized training in research conduct and ethics and health literacy is a promising strategy to reduce challenges in establishing and maintaining CABs and can also optimize CAB impact to address gaps in older Latino ADRD caregiving research.
Collapse
Affiliation(s)
- Maria M Quiñones
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | - Silvia Sörensen
- Warner School of Education and Human Development, University of Rochester, Rochester, New York, USA
| | - Kenneth Hepburn
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Jahaira Capellan
- Clinical Translational Science Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Kathi L Heffner
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| |
Collapse
|
7
|
Abstract
OBJECTIVES The present study sought to examine the association between sleep disturbance, mental health symptoms, and quality of life among informal caregivers. The study also aimed to assess whether greater caregiver demands (i.e., hours spent providing care per week) altered the associations between these physical and mental health outcomes. METHODS 530 informal caregivers participated in an online study of sleep and health across the lifespan. Sleep disturbance was assessed via the Insomnia Severity Index and RU-SATED. Mental health was measured using the PHQ-2, GAD-2, and the PANAS. Quality of life was assessed via the Satisfaction with Life Scale. RESULTS Results revealed an indirect association between sleep disturbance and quality of life via increased mental health symptoms (β = -.21, p =.001). This indirect association was moderated by caregiver demands (β =.33, p =.002), with higher caregiving demands increasing the association between sleep disturbance and quality of life. CONCLUSIONS Findings highlight the adverse outcomes associated with sleep disturbance among caregivers and suggest that higher caregiving demands increases the effect of sleep disturbance on quality of life. CLINICAL IMPLICATIONS Increased caregiving is associated with adverse physical and mental health consequences. Assessing and treating sleep disturbance among caregivers is needed and may lead to improvements in mental health and quality of life.
Collapse
Affiliation(s)
- Scott G Ravyts
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Joseph M Dzierzewski
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| |
Collapse
|
8
|
Turner SG, Robinson JRM, Pillemer KA, Reid MC. Prevalence Estimates of Arthritis and Activity-Limiting Pain Among Family Caregivers to Older Adults. Gerontologist 2024; 64:gnad124. [PMID: 37656675 PMCID: PMC11020308 DOI: 10.1093/geront/gnad124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Little is known about the prevalence of physical pain among family caregivers to older adults. We used national survey data to assess the relative prevalence of caregivers' arthritis and activity-limiting bothersome pain by caregiver and care-recipient characteristics to identify which caregivers may be at a higher risk for physical pain. RESEARCH DESIGN AND METHODS We analyzed data collected from 1,930 caregivers who participated in the National Study on Caregiving (2017). We utilized modified Poisson models to estimate adjusted associations of caregiver and care-recipient characteristics with the relative prevalence of arthritis and bothersome pain. RESULTS Forty percent of caregivers had a lifetime diagnosis of arthritis. Seventy-five percent of caregivers with arthritis reported bothersome pain, nearly 30% of whom endorsed bothersome pain that limited their activities on most or every day of the previous month (i.e., activity-limiting bothersome pain). Regardless of whether they had arthritis, 51% of the sample reported bothersome pain in the previous month, 24% of whom indicated activity-limiting bothersome pain. Caregivers who were older or more highly educated had a higher prevalence of arthritis. Black caregivers had a lower prevalence of arthritis and activity-limiting bothersome pain compared to White caregivers. Caregivers with physical difficulty providing care had a higher prevalence of arthritis and activity-limiting bothersome pain than caregivers without physical difficulty providing care. DISCUSSION AND IMPLICATIONS Arthritis and activity-limiting bothersome pain are highly prevalent among caregivers. Given increased prevalence of pain among certain caregivers, it may be efficient to target these groups for pain management interventions.
Collapse
Affiliation(s)
- Shelbie G Turner
- Weill Cornell Medical College, Division of Geriatrics and Palliative Medicine, New York City, New York, USA
| | | | - Karl A Pillemer
- Weill Cornell Medical College, Division of Geriatrics and Palliative Medicine, New York City, New York, USA
- College of Human Ecology, Cornell University, Ithaca, New York, USA
| | - M Carrington Reid
- Weill Cornell Medical College, Division of Geriatrics and Palliative Medicine, New York City, New York, USA
| |
Collapse
|
9
|
Govil D, Sahoo H, Chowdhury B, James KS. A qualitative perspective of working women care providers and care receivers on eldercare: a study from India. BMC Geriatr 2024; 24:345. [PMID: 38627618 PMCID: PMC11021006 DOI: 10.1186/s12877-024-04782-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/05/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The paper aims to explore the elderly caregiving process in India from the perspective of both elderly as well as working women care providers, along with the challenges faced and the coping strategies adopted by them during the process. METHODS In-depth interviews with 48 participants (care providers and care receivers) from 25 multi-generational households were conducted in the slums of Mumbai and analysed using QSR-NVivo-10. RESULTS Working women care providers supported the needs of the dependent elderly along with performing household chores and paid work. However, the way the care was perceived and demanded, was not often same as delivered by the care providers. Care provider suffered silently with poor social, physical and emotional welling in absence of support system and lack of time. Sometimes, physically exhausted care providers unknowingly resorted to elderly abuse and neglect. At the same time, a bidirectional flow of support from elderly also existed in the form of childcare, household chores and financial support. Though caregiving overstrained the care providers, strong family ties, acknowledgement of the contributions of the elderly during their young days, and the desire to set a precedent for the young generation did not let them step back from their duties. The main coping mechanism for both care receivers and providers was largely centred around the notion of acceptance of their situation. CONCLUSION Conversations between generations can help in enhancing family ties and reduce conflicts. The support of family and community can also ease the burden of caregiving.
Collapse
Affiliation(s)
- Dipti Govil
- International Institute for Population Sciences, Mumbai, India.
| | - Harihar Sahoo
- International Institute for Population Sciences, Mumbai, India
| | - Biswabandita Chowdhury
- S.P. Mandali's Prin. L. N. Welingkar Institute of Management Development & Research, Mumbai, India
| | - K S James
- International Institute for Population Sciences, Mumbai, India
| |
Collapse
|
10
|
Özkan Tuncay F. The Relationship Between Preparedness for Caregiving and Spiritual Well-Being in the Carers of Stroke Patients: A Case Study in Türkiye. J Relig Health 2024:10.1007/s10943-024-02033-4. [PMID: 38625637 DOI: 10.1007/s10943-024-02033-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 04/17/2024]
Abstract
This study was conducted to determine the relationship between preparedness for caregiving and spiritual well-being in the carers of stroke patients. This descriptive and cross-sectional study was conducted with 130 primary carers of patients hospitalized with the diagnosis of stroke at the neurology clinic of a hospital. It was determined that the participants had moderate levels of preparedness for caregiving, they had high levels of spiritual well-being, and there was a positive significant relationship between these two variables. According to the regression analysis results, the spiritual well-being level of the participants was a predictor of their preparedness for caregiving (B: 0.144, p < 0.001). The results of this study demonstrated that the spiritual well-being of the carers of stroke patients is important in increasing preparedness for caregiving. In this context, to ensure that the carers of all stroke patients feel prepared for the caregiving process, it is recommended to evaluate their preparedness levels, support them in their preparation for their caregiving roles, and identify their spiritual needs.
Collapse
Affiliation(s)
- Fatma Özkan Tuncay
- Department of Medical Nursing, Health Sciences Faculty, Cumhuriyet University, 58140, Sivas, Turkey.
| |
Collapse
|
11
|
Maleki M, Dehghan Nayeri N, Hamidieh AA, Pouraboli B, Mardani A. Harmony in hardship: Unveiling parental coping strategies with the challenges of child's hematopoietic stem cell transplantation. J Pediatr Nurs 2024:S0882-5963(24)00148-9. [PMID: 38616142 DOI: 10.1016/j.pedn.2024.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/21/2024] [Accepted: 04/06/2024] [Indexed: 04/16/2024]
Abstract
PURPOSE Pediatric Hematopoietic Stem Cell Transplant (HSCT) profoundly affects various dimensions of parents' lives. Effective coping strategies are essential for improving psychological well-being and overall quality of life. Therefore, this study aimed to explore parental coping strategies with their child's HSCT challenges. DESIGN AND METHODS This qualitative study was conducted in Iran from February to November 2023, utilizing conventional content analysis with purposive sampling. For data collection, unstructured interviews were conducted, followed by in-depth semi-structured interviews with open-ended questions. Saturation was reached after analyzing qualitative data from 20 participants. RESULTS Data analysis unveiled a main theme labeled "harmony in hardship". This overarching concept encapsulates the participants' endeavors to cope with the various hurdles and complexities stemming from their child's HSCT. This theme consisted of five categories: "emotional release", "positive coping", "avoidance coping", "spiritual coping", and "seeking support". CONCLUSION Parents utilized multifaceted coping strategies to manage the complexities of their child's HSCT journey. Understanding these mechanisms is crucial as they can positively influence parents' psychological well-being and improve their overall quality of life. IMPLICATIONS FOR CLINICAL PRACTICE Healthcare professionals should recognize the diverse coping strategies employed by parents of children undergoing HSCT and provide tailored interventions and support. Furthermore, implementing structured support programs and training initiatives for healthcare professionals can enhance their capacity to meet the diverse needs of parents during this challenging journey.
Collapse
Affiliation(s)
- Maryam Maleki
- Department of Pediatric and Neonatal Intensive Care Nursing Education, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Amir Ali Hamidieh
- Pediatric Cell and Gene Therapy Research Centre, Gene, Cell & Tissue Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Batool Pouraboli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Abbas Mardani
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran.
| |
Collapse
|
12
|
Park YS, Kim H, Jang SY, Park EC. Trends in private caregiving cost after implementing a comprehensive nursing service covered by national health insurance: Interrupted time series. Int J Nurs Stud 2024; 152:104689. [PMID: 38308934 DOI: 10.1016/j.ijnurstu.2024.104689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 01/01/2024] [Accepted: 01/01/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND The Korean government has implemented a comprehensive nursing care service system (CNS) to mitigate the stress faced by caregivers. OBJECTIVE This study aimed to assess trends in the estimated average costs of private caregiving and determine the difference in costs between those using CNS and those not using it. DESIGN A comparative interrupted time series analysis with a 2-year lag period verified total private caregiving cost trends; biannual differences in costs were evaluated based on using CNS. PARTICIPANTS The main unit of analysis was episode. We extracted a total of 6418 episodes of hospitalization in acute care settings that included the use of caregiving services (formal, informal caregiving and CNS). METHODS We conducted segmented regression to assess the impact of CNS on total private caregiving costs using data from 2012 to 2018, excluding the years 2015 and 2016 of the Korean Health Panel dataset. RESULTS We presented that the immediate mean difference in total private caregiving costs between CNS users and non-users was -444.7 USD two years after the implementation of the CNS policy (95 % CI -714.5 to -174.5, p-value 0.001). Among individuals living in rural areas, two years after the implementation of the CNS policy, there was a significant immediate mean cost difference of -476.9 USD in total private caregiving costs between CNS users and non-users (p-value 0.011). Similarly, for episodes with a Charlson Comorbidity Index (CCI) score of 0 to 1, there was a substantial immediate mean cost difference in total private caregiving costs between CNS users and non-users, amounting to -399.9 USD two years after the CNS policy (p-value 0.008). CONCLUSIONS This study evaluated the trend of total private caregiving costs between groups using and not using CNS. After two years of being covered by CNS health insurance, those who utilized CNS paid $433 less for their total private caregiving cost over a 6-month period, compared to those who did not use CNS. The adoption of CNS may be an effective system for relieving the financial burden on inpatients in need of private caregiving services. TWEETABLE ABSTRACT Korean Comprehensive Nursing Service reduces private caregiving costs.
Collapse
Affiliation(s)
- Yu Shin Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hyunkyu Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk-Yong Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
13
|
Downer B, Samper-Ternent R, Cantu P, Miller M, Wong R. Does a Reduction in Receiving Assistance With Daily Activities Among Older Adults in Mexico Indicate An Increase in Unmet Needs or a Decrease in Needs for Care? J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad192. [PMID: 38142132 PMCID: PMC10923212 DOI: 10.1093/geronb/gbad192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Indexed: 12/25/2023] Open
Abstract
OBJECTIVES The percentage of older adults in Mexico with difficulty completing activities of daily living (ADL) who receive assistance from family appears to be decreasing. We compared 2 birth cohorts of older adults in Mexico to investigate whether this trend reflects an increase in unmet caregiving needs or a decrease in the need for care. METHODS We selected Mexican Health and Aging Study participants aged 60-76 in 2001 (n = 4,805) and 2018 (n = 6,494). ADL tasks were dressing, walking, bathing, getting in and out of bed, and toileting. Participants who reported difficulty with an ADL were asked if anyone helped them with the task. Logistic regression was used to estimate adjusted odds ratios (aOR) for cohort differences in ≥1 ADL limitations and help with ≥1 ADL. We used a decomposition analysis to identify participant characteristics that mediated cohort differences in receiving help with ≥1 ADL. RESULTS The 2018 cohort had higher odds for ≥1 ADL limitations (aOR = 1.85, 95% CI = 1.60-2.14) but lower odds for help with ≥1 ADL (aOR = 0.66, 95% CI = 0.49-0.89). Among participants with ADL disability, the 2018 cohort had fewer living children and a lower prevalence of probable dementia. The lower number of living children and lower prevalence of probable dementia explained 9.34% and 43.7% of the cohort effect on receiving help with ≥1 ADL, respectively. DISCUSSION The declining percentage of older adults in Mexico with ADL disability receiving assistance may not reflect increasing unmet needs. However, the increased prevalence of ADL disability will increase the number of older adults needing informal care.
Collapse
Affiliation(s)
- Brian Downer
- Department of Population Health and Health Disparities, School of Public and Population Health, University of Texas Medical Branch, Galveston, Texas, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, USA
| | - Rafael Samper-Ternent
- Department of Management, Policy & Community Health, School of Public Health, University of Texas Health Sciences Center at Houston, Houston, Texas, USA
| | - Philip Cantu
- Department of Internal Medicine, John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Matthew Miller
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, USA
| | - Rebeca Wong
- Department of Population Health and Health Disparities, School of Public and Population Health, University of Texas Medical Branch, Galveston, Texas, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, USA
| |
Collapse
|
14
|
Sterba KR, Armeson K, Zapka J, Garrett-Mayer E, Scallion ML, Wall TK, Olsen J, Graboyes EM, Alberg AJ, Day TA. A pilot randomized controlled trial to evaluate a survivorship care planning intervention for head and neck cancer survivor-caregiver dyads. J Cancer Surviv 2024; 18:398-411. [PMID: 35761129 DOI: 10.1007/s11764-022-01227-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/14/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE Head and neck cancer (HNC) survivors and caregivers face significant challenges after treatment. This study's objective was to evaluate the effects of a dyadic survivorship care planning (SCP) intervention on survivor and caregiver outcomes. METHODS This randomized controlled trial enrolled HNC survivors and caregivers within 18 months post-treatment, randomized dyads to SCP (one-session with written SCP and follow-up telephone call) or usual care and administered baseline and 6-month surveys. Multivariable linear regression examined intervention effects on depression and unmet needs in dyads and burden on caregiverss and a set of secondary outcomes. Rating scales and open-ended questions assessed acceptability. RESULTS We randomized 89 survivor-caregiver dyads (42 usual care, 47 SCP dyads). Fidelity to SCP was high for most survivorship domains except discussing care barriers (13%). The most commonly discussed referrals included nutrition (83%) and behavioral medicine (38%), but referral uptake was low. The SCP intervention did not improve depression or unmet needs among dyads or burden among caregivers at 6 months relative to usual care (p's > .05). Nurses and dyads rated SCP favorably with > 80% positive ratings for session length and care plan content. Qualitative findings highlighted that SCP helped consolidate complex clinical information and strengthened survivor-caregiver-clinician relationships. CONCLUSIONS An HNC SCP intervention was acceptable but ineffective in improving dyads' outcomes. IMPLICATIONS FOR CANCER SURVIVORS Post-treatment SCP in HNC dyads was ineffective in improving outcomes in survivors and caregivers as delivered in this study. More research is needed to understand how to capitalize on the acceptability of the SCP approach and enhance its effectiveness to support dyads.
Collapse
Affiliation(s)
- Katherine R Sterba
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA.
| | - Kent Armeson
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
| | - Jane Zapka
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
| | - Elizabeth Garrett-Mayer
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
| | - Megan L Scallion
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
| | - Tiffany K Wall
- Department of Otolaryngology-Head and Neck Surgery and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA
| | - Jama Olsen
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
| | - Evan M Graboyes
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
- Department of Otolaryngology-Head and Neck Surgery and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA
| | - Anthony J Alberg
- Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street Room 465, Columbia, SC, 29208, USA
| | - Terry A Day
- Department of Otolaryngology-Head and Neck Surgery and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA
| |
Collapse
|
15
|
Harriman NW, Ohene-Kwofie D, Jung SJ, Hermosilla S, Gómez-Olivé FX, Jennings EA. In-Person Social Interactions and Anxiety During the COVID-19 Pandemic: Exploring the Role of Household Size and Virtual Social Contact Among Midlife and Older Black South African Adults. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad175. [PMID: 38124487 PMCID: PMC10941638 DOI: 10.1093/geronb/gbad175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES The current study investigates how physical distancing during the coronavirus disease 2019 (COVID-19) pandemic was associated with increased anxiety among a cohort of midlife older Black South African adults and the extent to which household size and virtual social contact modify this association for men and women. METHODS We analyze data from a phone survey conducted from July 2021 to March 2022 as part of Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (n = 2,080). We employ logistic regression to estimate the association between changes in in-person social interactions and anxiety symptoms and examine whether the association is modified by household size and changes in virtual social contact. We perform analyses separately for women and men. RESULTS Declines in in-person social interactions were associated with increased anxiety for women and men (odds ratios [OR] = 2.52, p < .001). For women only, declines were greater for those living in larger households (OR = 1.11, p = .032). Declines were buffered by increased virtual social contact for both women (OR = 0.55, p = .025) and men (OR = 0.45, p = .019). DISCUSSION Although the anxiety symptoms of women and men were similarly affected by declines in in-person social interaction, the modifying influence of household size is unique to women, likely due to gender-specific social roles. For women, living in larger households may mean greater caregiving burden, exacerbating the detrimental association between physical distancing and anxiety. On the other hand, both women and men may have used virtual means to connect with friends and family living outside their homes, buffering against increased anxiety.
Collapse
Affiliation(s)
- Nigel Walsh Harriman
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, Massachusetts, USA
| | - Daniel Ohene-Kwofie
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Sun Jae Jung
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, Massachusetts, USA
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Sabrina Hermosilla
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Elyse A Jennings
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, Massachusetts, USA
| |
Collapse
|
16
|
Felber NA, Lipworth W, Tian YJA, Roulet Schwab D, Wangmo T. Informing existing technology acceptance models: a qualitative study with older persons and caregivers. Eur J Ageing 2024; 21:12. [PMID: 38551677 PMCID: PMC10980672 DOI: 10.1007/s10433-024-00801-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 04/01/2024] Open
Abstract
New technologies can help older persons age in place and support their caregivers. However, they need to be accepted by the end-users to do so. Technology acceptance models, such as TAM and UTAUT and their extensions, use factors like performance expectancy and effort expectancy to explain acceptance. Furthermore, they are based on quantitative methods. Our qualitative study investigates factors fostering and hindering acceptance among older persons and their caregivers for a variety of assistive technologies, including wearables, ambient sensors at home with and without cameras and social companion robots. The goal of this paper is twofold: On the one hand, it investigates the factors of technology acceptance models in a qualitative setting. On the other hand, it informs these models with aspects currently overlooked by them. The results reveal that performance expectancy and effort expectancy are relevant for acceptance. We also find that reliability, anxiety around technology and different social aspects have an influence on acceptance of assistive technology in aged care for all end-user groups. Our findings can be used to update current technology acceptance models and provide in-depth knowledge about the currently used factors.
Collapse
Affiliation(s)
- Nadine Andrea Felber
- Institute of Biomedical Ethics, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland.
- Department of Philosophy, Macquarie University, 25B Wally's Walk, Sydney, NSW, 2109, Australia.
| | - Wendy Lipworth
- Department of Philosophy, Macquarie University, 25B Wally's Walk, Sydney, NSW, 2109, Australia.
| | - Yi Jiao Angelina Tian
- Institute of Biomedical Ethics, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
| | - Delphine Roulet Schwab
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Tenzin Wangmo
- Institute of Biomedical Ethics, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
| |
Collapse
|
17
|
Martani A, Tian YJA, Felber N, Wangmo T. Gerontechnologies, ethics, and care phases: Secondary analysis of qualitative interviews. Nurs Ethics 2024:9697330241238340. [PMID: 38470960 DOI: 10.1177/09697330241238340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
BACKGROUND Gerontechnologies are increasingly used in the care for older people. Many studies on their acceptability and ethical implications are conducted, but mainly from the perspective of principlism. This narrows our ethical gaze on the implications the use of these technologies have. RESEARCH QUESTION How do participants speak about the impact that gerontechnologies have on the different phases of care, and care as a process? What are the moral implications from an ethic of care perspective? RESEARCH DESIGN Secondary analysis of semi-structure interviews, whose segments on specific technologies were analysed through reflexive thematic analysis. PARTICIPANTS AND RESEARCH CONTEXT Sixty-seven Swiss stakeholders involved in the use of gerontechnologies, including professional caregivers, informal caregivers, and older persons themselves. ETHICAL CONSIDERATIONS The research study was evaluated by the Ethics Commission of Northwest and Central Switzerland (EKNZ). All participants received an information document before the interview date detailing the purpose, procedure, and anonymization measures. After explaining the study during the agreed upon interview time and upon receiving their written informed consent, the interview process began. FINDINGS/RESULTS Four themes are identified: Identifying care needs, Taking responsibility, Hands-on work, Responding to care. As part of these themes, many codes highlighting the ambivalent impact of gerontechnologies are created, ranging from 'Expanded capacity for…identifying care needs' to 'Create new & (un)necessary…hands-on work'. The moral implications of these results from the care ethics perspective are discussed, through the ethical elements of: attentiveness, responsibility, competence, and responsiveness. CONCLUSIONS The moral implications of gerontechnologies on care phases from the care ethics perspective open up several questions on whether they actually help give care a central role in social life and provide more competent care.
Collapse
|
18
|
Petrovsky DV, Yildiz M, Yefimova M, Sefcik JS, Baker ZG, Ma KPK, Rahemi Z, Bacsu JDR, Smith ML, Pickering CEZ. Shared Activities as a Protective Factor Against Behavioral and Psychological Symptoms of Dementia and Caregiver Stress. Innov Aging 2024; 8:igae034. [PMID: 38660116 PMCID: PMC11037273 DOI: 10.1093/geroni/igae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Indexed: 04/26/2024] Open
Abstract
Background and Objectives Most persons with dementia experience behavioral and psychological symptoms (BPSD). While there is evidence that structured activity programs can be beneficial for persons with dementia and their caregivers, it is not well understood how joint engagement in shared activities affects BPSD and caregiver stress. The purpose of this study was to examine the moderating effect of doing a shared activity on the BPSD and caregiver stress. Research Design and Methods This study used an intensive longitudinal observational design in which caregivers completed baseline and once-a-day diary surveys for 21 days. Caregivers were asked whether they did a pleasant noncare activity with their relative, the presence of 8 BPSD, and their stress level. A moderation model in a structural equation model examined the relationship between these variables. Results Our sample consisted of 453 caregivers (87.4% female, 51.4% non-Hispanic White, mean age 53 years [standard deviation {SD}: 14]) and person living with dementia whose mean age was 79 years (SD: 9). On days when the caregivers engaged in a shared activity together with person living with dementia, there was a significant decrease in the BPSD (estimate -0.038, standard error [SE] = 0.016, 95% confidence interval [CI]: -0.069, -0.007, p value = 0.018). The effects of engaging in a shared activity decreased the impact of caregiver stress by 0.052 (estimate -0.052, SE = 0.018, 95% CI: -0.087, -0.017, p value = 0.004). At the between-person level, no differences were found in BPSD across caregivers who engaged or did not engage in shared activities. Discussion and Implications The results of our study indicate that doing a shared activity is associated with reduced BPSD among persons with dementia and may buffer the impact of caregiver stress on BPSD. Shared activities should be considered a key intervention component for dementia caregivers.
Collapse
Affiliation(s)
- Darina V Petrovsky
- Division of Women, Children, & Families, Duke University School of Nursing, Durham, North Carolina, USA
| | - Mustafa Yildiz
- Department of Research, Jane and Robert Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Maria Yefimova
- Center for Nursing Excellence & Innovation, University of California, San Francisco, San Francisco, California, USA
- Department of Physiological Nursing, UCSF School of Nursing, San Francisco, California, USA
| | - Justine S Sefcik
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
| | - Zachary G Baker
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Kris Pui Kwan Ma
- Department of Family Medicine, University of Washington, Seattle, Washington, USA
| | - Zahra Rahemi
- School of Nursing, Clemson University, Greenville, South Carolina, USA
| | | | - Matthew Lee Smith
- Department of Health Behavior, Texas A&M University School of Public Health, College Station, Texas, USA
| | - Carolyn E Z Pickering
- Department of Research, Jane and Robert Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, Texas, USA
| |
Collapse
|
19
|
Methi F, Nes RB, Skirbekk V, Hansen T. The double-edged sword of becoming a caregiver: dynamic impact on four dimensions of well-being in Norway. BMC Psychol 2024; 12:120. [PMID: 38439109 PMCID: PMC10913458 DOI: 10.1186/s40359-024-01623-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/25/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Becoming a caregiver can be a transformative journey with profound, multifaceted implications for well-being. However, existing research predominantly emphasizes the negative aspects of caregiving, paying less attention to the positive sides. This study aims to explore the impact of transitioning into a caregiving role on various well-being indicators, such as negative hedonic, positive hedonic, eudaimonic, and social well-being. METHODS We use Norwegian panel data (2019-2021) and employ a combination of nearest-neighbour matching and a difference-in-differences approach to analyse well-being trajectories among new caregivers (n = 304) and non-caregivers (n = 7822). We assess ten items capturing the dimensions of negative hedonic (anxiousness, sadness, and worriedness), positive hedonic (happiness and life satisfaction), eudaimonic (contributing to others' happiness, engagement, and meaning), and social (strong social relations and loneliness) well-being. RESULTS Our results show a general increase in negative hedonic well-being and a decline in positive hedonic well-being for new caregivers. These impacts are larger for caregivers providing daily care, compared to those providing weekly and monthly care, and for those providing care inside rather than outside their own household. We observe only minor differences regarding gender and age. Interestingly, we also notice neutral or beneficial changes for eudaimonic aspects of well-being; of note, caregivers generally experience an increased sense of contributing to others' happiness. CONCLUSION Our study reveals that adopting a caregiving role often leads to significant psychosocial challenges, especially in intensive caregiving situations. However, it also uncovers potential positive influences on eudaimonic aspects of well-being. Future research should explore underlying explanatory mechanisms, to inform strategies that enhance caregivers' well-being.
Collapse
Affiliation(s)
- Fredrik Methi
- Department of Health Services, Norwegian Institute of Public Health, Postboks 222, Skøyen, N-0213, Oslo, Norway.
| | - Ragnhild Bang Nes
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, University of Oslo, Oslo, Norway
- Department of Philosophy, Classics, and History of Arts and Ideas, University of Oslo, Oslo, Norway
| | - Vegard Skirbekk
- Center for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Thomas Hansen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, University of Oslo, Oslo, Norway
- Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
20
|
Andersen L, Baker KM, Difilippo H, Meghani SH, Porter D, Deng J. The Patient Symptom Experience After Tisagenlecleucel and Lisocabtagene Maraleucel CAR T-Cell Therapy for Lymphoma. Semin Oncol Nurs 2024:151614. [PMID: 38443220 DOI: 10.1016/j.soncn.2024.151614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/21/2024] [Accepted: 02/01/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVES Chimeric Antigen Receptor (CAR) T-cell treatment is associated with several unique toxicities, and the short-term symptom trajectory in the immediately after therapy is well-documented. However, little is known about patients' long-term symptom experience. The study aimed to elicit the symptom experience of adult patients in remission after CAR T-cell therapy for B cell lymphoma. DATA SOURCES A qualitative descriptive design with thematic analysis was utilized. Recruitment occurred at a tertiary academic medical center using the following inclusion criteria: adult recipient of CAR T-cell therapy for B-cell lymphoma between 3 and 12 months prior to enrollment, and currently in remission. Semi-structured interviews were conducted, transcripts were inductively coded, and team members met weekly to ensure rigor. The final sample included 10 patients: Seven received tisagenlecleucel and three received lisocabtagene marleucel and were a median of 169 days post-infusion and 65 years of age. CONCLUSIONS Participants continued to report symptoms, including fatigue, neuropathy, low endurance, insomnia, memory problems, and pain. Most symptoms improved over time. Some symptoms interfered with social activities, work, driving, and physical activity, though participants reported that most symptoms existed prior to CAR T-cell therapy, and overall, found CAR T-cell therapy acceptable. IMPLICATIONS FOR NURSING PRACTICE Patients in remission after CAR T-cell therapy often continue to experience symptoms. Nurses should continue to assess this growing patient population and determine if patients require additional symptom management or support. Further research is needed to understand long-term symptom trajectory and associations with prior lines of therapy and CAR T-cell therapy.
Collapse
Affiliation(s)
- Lucy Andersen
- Department of Biobehavioral Health Sciences, School of Nursing, The University of Pennsylvania, Philadelphia, PA.
| | - Kayla M Baker
- Department of Biobehavioral Health Sciences, School of Nursing, The University of Pennsylvania, Philadelphia, PA
| | - Heather Difilippo
- Cell Therapy and Transplant Program, Abramson Cancer Center at the University of Pennsylvania, and Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA
| | - Salimah H Meghani
- Department of Biobehavioral Health Sciences, School of Nursing, The University of Pennsylvania, Philadelphia, PA
| | - David Porter
- Cell Therapy and Transplant Program, Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA
| | - Jie Deng
- Department of Biobehavioral Health Sciences, School of Nursing, The University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
21
|
Katus L, Crespo-Llado MM, Milosavljevic B, Saidykhan M, Njie O, Fadera T, McCann S, Acolatse L, Perapoch Amadó M, Rozhko M, Moore SE, Elwell CE, Lloyd-Fox S. It takes a village: Caregiver diversity and language contingency in the UK and rural Gambia. Infant Behav Dev 2024; 74:101913. [PMID: 38056188 DOI: 10.1016/j.infbeh.2023.101913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/28/2023] [Accepted: 11/26/2023] [Indexed: 12/08/2023]
Abstract
INTRODUCTION There is substantial diversity within and between contexts globally in caregiving practices and family composition, which may have implications for the early interaction's infants engage in. We draw on data from the Brain Imaging for Global Health (BRIGHT, www.globalfnirs.org/the-bright-project) project, which longitudinally examined infants in the UK and in rural Gambia, West Africa. In The Gambia, households are commonly characterized by multigenerational, frequently polygamous family structures, which, in part, is reflected in the diversity of caregivers a child spends time with. In this paper, we aim to 1) evaluate and validate the Language Environment Analysis (LENA) for use in the Mandinka speaking families in The Gambia, 2) examine the nature (i.e., prevalence of turn taking) and amount (i.e., adult and child vocalizations) of conversation that infants are exposed to from 12 to 24 months of age and 3) investigate the link between caregiver diversity and child language outcomes, examining the mediating role of contingent turn taking. METHOD We obtained naturalistic seven-hour-long LENA recordings at 12, 18 and 24 months of age from a cohort of N = 204 infants from Mandinka speaking households in The Gambia and N = 61 infants in the UK. We examined developmental changes and site differences in LENA counts of adult word counts (AWC), contingent turn taking (CTT) and child vocalizations (CVC). In the larger and more heterogenous Gambian sample, we also investigated caregiver predictors of turn taking frequency. We hereby examined the number of caregivers present over the recording day and the consistency of caregivers across two subsequent days per age point. We controlled for children's cognitive development via the Mullen Scales of Early Learning (MSEL). RESULTS Our LENA validation showed high internal consistency between the human coders and automated LENA outputs (Cronbach's alpha's all >.8). All LENA counts were higher in the UK compared to the Gambian cohort. In The Gambia, controlling for overall neurodevelopment via the MSEL, CTT at 12 and 18 months predicted CVC at 18 and 24 months. Caregiver consistency was associated with CTT counts at 18 and 24 months. The number of caregivers and CTT counts showed an inverted u-shape relationship at 18 and 24 months, with an intermediate number of caregivers being associated with the highest CTT frequencies. Mediation analyses showed a partial mediation by number of caregivers and CTT and 24-month CVC. DISCUSSION The LENA provided reliable estimates for the Mandinka language in the home recording context. We showed that turn taking is associated with subsequent child vocalizations and explored contextual caregiving factors contributing to turn taking in the Gambian cohort.
Collapse
Affiliation(s)
- Laura Katus
- Institute for Lifecourse Development, School of Human Sciences, University of Greenwich, UK; Centre for Family Research, University of Cambridge, UK.
| | | | - Bosiljka Milosavljevic
- Department of Biological and Experimental Psychology, Queen Mary University of London, UK
| | - Mariama Saidykhan
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, UK
| | - Omar Njie
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, UK
| | - Tijan Fadera
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, UK
| | - Samantha McCann
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, UK; Department of Women and Children's Health, Kings College London, UK
| | - Lena Acolatse
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, UK
| | | | - Maria Rozhko
- Department of Psychology, University of Cambridge, UK
| | - Sophie E Moore
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, UK; Department of Women and Children's Health, Kings College London, UK
| | - Clare E Elwell
- Department of Medical Physics and Biomedical Engineering, UK
| | | |
Collapse
|
22
|
Peterson LJ, Hackett SE, Dobbs D, Haley WE. Dementia Caregivers' Perspectives on Disaster Preparedness: Barriers, Resources, and Recommendations. Gerontologist 2024; 64:gnad076. [PMID: 37351950 DOI: 10.1093/geront/gnad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Disaster preparedness is an urgent concern, particularly for caregivers of persons with dementia. Developing and executing plans for oneself and another person who needs care can be difficult when the care recipient is cognitively impaired. We sought to better understand caregivers' disaster preparedness for the purpose of generating guidance for future interventions to increase caregiver resilience. RESEARCH DESIGN AND METHODS We conducted a qualitative descriptive study of caregiver disaster experiences and perceptions of their preparedness. Fifty-two participants from diverse backgrounds participated in a focus group or interview. Deductive thematic data analysis was utilized to identify themes. Stress process models guided the interpretation of our findings. RESULTS Analyses of caregivers' experiences and observations revealed that disaster preparedness was challenging for caregivers, though also perceived to be an important responsibility. We identified 3 main themes: (a) barriers to preparing for a disaster as a caregiver for a person living with dementia, (b) why it is important for a caregiver to develop a disaster plan, and (c) how to facilitate preparedness for caregivers of persons living with dementia. DISCUSSION AND IMPLICATIONS This study highlighted the difficulties of preparing for a disaster while caring for a person with dementia. Applying stress process models to our results provided strong evidence that interventions could be developed to bolster caregivers' resources to cope with stressors associated with disaster preparedness. A key issue for public officials is the question of whether disaster shelters are appropriate for persons with dementia.
Collapse
Affiliation(s)
- Lindsay J Peterson
- School of Aging Studies, Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida, USA
| | - Sara E Hackett
- School of Aging Studies, Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida, USA
| | - Debra Dobbs
- School of Aging Studies, Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida, USA
| | - William E Haley
- School of Aging Studies, Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida, USA
| |
Collapse
|
23
|
Dey D, Tripathi P. 'Robbed out of mind': Reflections on Alzheimer's and gendered subjectivity in select Indian literary narratives. J Aging Stud 2024; 68:101211. [PMID: 38458719 DOI: 10.1016/j.jaging.2024.101211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/08/2024] [Accepted: 01/18/2024] [Indexed: 03/10/2024]
Abstract
Neurological degeneration is a potent signifier molding older lives, divesting them of 'personhood' and making them a 'target of care'. This article delineates the depictions of Alzheimer's and its associated losses in select Indian literary narratives- Jalsobi: In the Shadow of Light (2018) and Girl in White Cotton (2019) and seeks to understand how 'ageing into disability' for older women has severe implications that marginalize their embodied existence, foisting a symbolic death. Through the fictional accounts, the article explores two primary threads of consideration - how the 'selfhood' gets eroded/reclaimed while experiencing cognitive impairment and how the shift from the patient-centric to the person-centric approach alters the relational care dynamics in the Indian context. It also attempts to situate the conception and representation of age-induced cognitive loss within the framework of critical disability studies, which understates the reductionist biomedical perspective and fosters an alternative, inclusive, and empathetic understanding of dysfunctionality.
Collapse
Affiliation(s)
- Debashrita Dey
- Department of Humanities and Social Sciences, Indian Institute of Technology Patna, India
| | - Priyanka Tripathi
- Department of Humanities and Social Sciences, Indian Institute of Technology Patna, India.
| |
Collapse
|
24
|
Brear MR, Manderson L, Nkovana T, Harling G. Conceptualisations of "good care" within informal caregiving networks for older people in rural South Africa. Soc Sci Med 2024; 344:116597. [PMID: 38320434 DOI: 10.1016/j.socscimed.2024.116597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/12/2023] [Accepted: 01/10/2024] [Indexed: 02/08/2024]
Abstract
Good care in social policy statements is commonly implied as familial and person-centred, provided by family members and focused on upholding the autonomy, dignity and respect of the care recipient. Policy consideration of the relational nature of caregiving, the sociomaterial determinants of good care, the practical knowledge of caregivers and responsibilities of the state, is limited. Drawing on the ethics of care theory and a care ecology framework, which conceptualises the dynamic interactions between formal and informal care "systems," we analysed ethnographic data of the interactions of 21 caregivers and their older care recipients in South Africa to understand how they conceptualised good care. Conceptualisations of good care included: having the right, altruistic and reciprocal, motivations; providing care frequently and consistently; and demonstrating hope for a better future through practical action. Caregivers also considered restricting autonomy a feature of good care, when doing so was perceived to be in the care recipient's best interest. Conceptualisations of good care were influenced by but also countered policy and cultural ideals. When they subverted policy values and practices, by overriding autonomy, for instance, caregivers' conceptualisations reflected their practical experiences of caregiving amidst gross material inadequacies, underpinned by deficiencies in the formal care system. We highlight the need for policies, interventions and theories of care that focus broadly on the care ecology and particularly on the "carescape" (formal care system). We advocate relational approaches that consider and balance the needs, desires and rights of caregivers and care recipients, and recognise caregivers' experiential knowledge, rather than person-centred approaches that focus exclusively on the care recipient.
Collapse
Affiliation(s)
- Michelle R Brear
- School of Public Health, University of the Witwatersrand, South Africa; Monash University, Australia.
| | - Lenore Manderson
- School of Public Health, University of the Witwatersrand, South Africa; Monash University, Australia
| | | | - Guy Harling
- School of Public Health, University of the Witwatersrand, South Africa; University College London, United Kingdom; Africa Health Research Institute, South Africa; University of KwaZulu-Natal, South Africa
| |
Collapse
|
25
|
Chiang HLM. "It'll never end, I'll never go": Representation of Caregiving in Samuel Beckett's Endgame and Footfalls. J Med Humanit 2024; 45:79-93. [PMID: 37341852 DOI: 10.1007/s10912-023-09805-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/22/2023]
Abstract
Research on the unrepresentability of death in Samuel Beckett's oeuvre abound in Beckett scholarship, but little attention has been given to the artist's representation of caregiving to the dying in his plays. With reference to Martin Heidegger's concept of care and Albert Camus's idea of the absurd, this article analyzes Endgame (1957) and Footfalls (1976) by attending to Beckett's dramatic representation of caregiving as undergirded by a sense of its absurdity. The almost 20-year gap between the writing of both plays highlights the development of an understanding that this sense of absurdity is never about the caregiver's questioning of one's obligation to the dependent but about how one chooses to respond to caregiving as an absurd predicament. The pertinence of such a representation of caregiving by Beckett lies in its poignant articulation of a complex experience that is often left unexpressed by caregivers who prioritize their dependent loved ones over themselves.
Collapse
Affiliation(s)
- Hui Ling Michelle Chiang
- School of Humanities, Nanyang Technological University, 48 Nanyang Avenue, SHHK-03-69, Singapore, 639818, Singapore.
| |
Collapse
|
26
|
Leszko M, Allen DJ. Caring From a Distance: Experiences of Polish Immigrants in the United States Providing Care to Parents With Dementia Overseas. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad086. [PMID: 37288778 DOI: 10.1093/geronb/gbad086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVES Aging populations and an increasing number of immigrants in recent years have led to numerous changes in intergenerational relationships. Although many studies have investigated the impact of providing care to a parent with dementia, little is known about the impact of caregiving activities provided from a distance, such as in the case of immigration, and over a long period of time to a person with dementia. Our understanding of how transnational caregiving for a person with dementia affects relationships is also limited. Using the Intergenerational Solidarity Theory as a theoretical framework, this paper examines the experiences of adult children and immigrant caregivers of a parent with dementia living in Poland. METHODS A qualitative, semistructured interview was conducted with 37 caregivers living in the United States while providing transnational care to a parent with Alzheimer's disease or other forms of dementia. The data analysis was based on the thematic analysis strategy. RESULTS Four themes were identified: (1) filial obligations and solidarity, (2) caregivers' contradictory emotions regarding transnational care, (3) financial and emotional exhaustion, and (4) challenges of nursing home dilemmas. DISCUSSION Transnational caregivers represent a unique group who face distinctive challenges related to competing demands and limited resources. This study contributes to a better understanding of their experiences whereas the findings highlight the importance of addressing the mental and physical well-being of immigrant caregivers of individuals with dementia and have important implications for health care professionals and immigration policies. Implications for future research were also identified.
Collapse
Affiliation(s)
- Magdalena Leszko
- Department of Psychology, University of Szczecin, Szczecin, Poland
| | - Dorota J Allen
- Department of Child Development and Family Studies, Purdue University, Hammond, Indiana, USA
| |
Collapse
|
27
|
Cheong JL, Goh ZH, Schrag A. Support needs of people with Multiple System Atrophy. Parkinsonism Relat Disord 2024; 120:106019. [PMID: 38350294 DOI: 10.1016/j.parkreldis.2024.106019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Multiple system atrophy (MSA) is a neurodegenerative disease with presentations including parkinsonism, autonomic disturbances, gait impairment and mood disorders. The progressive nature of MSA results in a significant deterioration in quality of life for patients. OBJECTIVES To investigate the needs of people with MSA (PwMSA) in the United Kingdom (UK) and the support provided to them. METHODS A survey of members of the UK's MSA Trust including PwMSA and former carers explored questions on the physical, emotional, personal and financial impact of MSA and on support received. RESULTS There were 284 valid responses from PwMSA and 371 responses from former carers. Difficulties with movement were universally experienced by PwMSA. The majority of former carers reported these as difficult or very difficult to manage (90 %), followed by autonomic problems (85 %) and breathing, speech or swallowing problems (81 %). PwMSA also reported fatigue (96 %), mood disorders (80 %) and social isolation (82 %). 41 % of former carers felt that the emotional needs of PwMSA had not been met. Many also reported inadequately covered financial needs (48 %). Equipment used most commonly included mobility equipment (90 %). The majority received support from neurologists (95 %) and GPs (92 %), but few from palliative care or mental health professionals. Satisfaction was highest for support from palliative services (95 %) and specialist nurses (91 %). CONCLUSION This survey demonstrates the high burden of MSA across various aspects of life for PwMSA. It suggests that whilst there is good provision of neurology services and physical equipment, there is a need to improve support for their emotional and social needs.
Collapse
Affiliation(s)
- Julia Ly Cheong
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Zhao Hk Goh
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, UK.
| |
Collapse
|
28
|
Sung P, Lim-Soh J, Malhotra R. Informal Caregiver Social Network Types and Mental Health: The Mediating Role of Psychological Resilience. J Aging Soc Policy 2024:1-16. [PMID: 38424034 DOI: 10.1080/08959420.2024.2319535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 11/13/2023] [Indexed: 03/02/2024]
Abstract
Little is known about whether and why social networks protect mental health among informal caregivers. This study examined the association between informal caregiver social network types and depressive symptoms and the mediatory mechanism of psychological resilience. Latent class analysis, applied to cross-sectional data on 278 Singaporean caregivers, identified four social network types: restricted (42%), friend (16%), family (21%), and diverse (21%). Path analysis showed that the diverse social network type, compared to the restricted social network type, was associated with a lower level of depressive symptoms, and psychological resilience fully mediated this association. Interventions should help caregivers to maintain social networks with their family and friends.
Collapse
Affiliation(s)
- Pildoo Sung
- Department of Sociology, Hong Kong Baptist University, Hong Kong, China
| | - Jeremy Lim-Soh
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
| | - Rahul Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| |
Collapse
|
29
|
Caton L, Short N, Goetzinger A, Chidgey B, Austin A. "My Goal is…to get Through the Day Without Pain": A Qualitative Study on Chronic Pain Experiences and Treatment Needs Among Child Caregiving Women. Matern Child Health J 2024:10.1007/s10995-024-03915-5. [PMID: 38401026 DOI: 10.1007/s10995-024-03915-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION We aimed to understand connections between pain, caregiving, physical and behavioral health treatment needs, and motivations for prescription opioid use among child caregiving women with chronic pain. METHODS We conducted in-depth, semi-structured interviews with 12 women (average age 48 years; 58% Black) in child caregiving roles, including women who were pregnant or trying to become pregnant and were caring for children or grandchildren < 18 years, and who received treatment at an outpatient pain management clinic. We used thematic text analysis to identify qualitative themes related to caregiving, pain, treatment, substance use, coping strategies, and sources of support. RESULTS A diverse sample of women reported high levels of stress and pain, substance use, interpersonal violence, depression, and financial strain. Most described difficulties at work, interacting with children or grandchildren, and engaging routine, daily activities due to their pain. Most indicated that they spent less time with family and friends due to their pain and had limited sources of support to help them navigate both caregiving and pain. Many described barriers to receiving appropriate healthcare, including prescription opioids, due to stigma or logistics, though most also reported positive healthcare experiences. Women also reported added daily-life, physical, mental health, and interpersonal stressors and difficulty navigating the healthcare system to receive needed care. DISCUSSION For women with chronic pain in child caregiver roles, results highlight the importance of care tailored to the physical needs of child caregiving and of trauma-informed approaches given the prevalence of comorbid conditions and trauma.
Collapse
Affiliation(s)
- Lauren Caton
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nicole Short
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV, USA
- Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amy Goetzinger
- Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brooke Chidgey
- Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anna Austin
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, 401 Pittsboro St, CB #7445, Chapel Hill, NC, 27599- 7445, 623-7578, USA.
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| |
Collapse
|
30
|
Humphreys KL, Garon-Bissonnette J, Hill KE, Bailes LG, Barnett W, Hare MM. Caregiving relationships are a cornerstone of developmental psychopathology. Dev Psychopathol 2024:1-14. [PMID: 38389283 DOI: 10.1017/s0954579424000300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
The interdisciplinary field of developmental psychopathology has made great strides by including context into theoretical and empirical approaches to studying risk and resilience. Perhaps no context is more important to the developing child than their relationships with their caregivers (typically a child's parents), as caregivers are a key source of stimulation and nurturance to young children. Coupled with the high degree of brain plasticity in the earliest years of life, these caregiving relationships have an immense influence on shaping behavioral outcomes relevant to developmental psychopathology. In this article, we discuss three areas within caregiving relationships: (1) caregiver-child interactions in everyday, naturalistic settings; (2) caregivers' social cognitions about their child; and (3) caregivers' broader social and cultural context. For each area, we provide an overview of its significance to the field, identify existing knowledge gaps, and offer potential approaches for bridging these gaps to foster growth in the field. Lastly, given that one value of a scientific discipline is its ability to produce research useful in guiding real-world decisions related to policy and practice, we encourage developmental psychopathology to consider that a focus on caregiving, a modifiable target, supports this mission.
Collapse
Affiliation(s)
- Kathryn L Humphreys
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | | | - Kaylin E Hill
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Lauren G Bailes
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Whitney Barnett
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Megan M Hare
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| |
Collapse
|
31
|
Reckrey JM, Russell D, Fong MC, Burgdorf JG, Franzosa EC, Travers JL, Ornstein KA. Home Care Worker Continuity in Home-Based Long-Term Care: Associated Factors and Relationships With Client Health and Well-Being. Innov Aging 2024; 8:igae024. [PMID: 38505005 PMCID: PMC10946305 DOI: 10.1093/geroni/igae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Indexed: 03/21/2024] Open
Abstract
Background and Objectives Despite the importance of provider continuity across healthcare settings, continuity among home care workers who provide hands-on long-term care is understudied. This project describes home care worker continuity, identifies factors associated with increased continuity, and examines associations between continuity and client outcomes. Research Design and Methods We conducted a retrospective cohort study of clients receiving Medicaid-funded home-based long-term care (n = 3,864) using insurance plan and home care agency data from a large nonprofit organization. We estimated home care worker continuity for clients between 6-month clinical assessments using Bice-Boxerman scores. We then used generalized estimating equations to model associations between home care worker continuity and (1) client characteristics (e.g., cognitive impairment), and (2) client functional, health, and psychosocial outcomes. Results While home care worker continuity was lowest for clients receiving the most weekly care hours, a range of continuity existed across all levels of care need. Those who were male, older, Asian/Pacific Islander/Native American, cognitively impaired, and functionally impaired had lower continuity. Higher home care worker continuity was significantly associated (p < .05) with fewer falls, a higher likelihood of functional improvement/stabilization, and fewer depressive symptoms. Discussion and Implications The finding that home care worker continuity is associated with the health and well-being of home-based long-term care clients underscores the importance of building high-quality relationships in long-term care. Continued efforts are necessary to understand and advance home care worker continuity and to identify other aspects of the home care experience that benefit those receiving long-term care at home.
Collapse
Affiliation(s)
- Jennifer M Reckrey
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - David Russell
- VNS Health Center for Home Care Policy & Research, New York City, New York, USA
- Department of Sociology, Appalachian State University, Boone, North Carolina, USA
| | - Mei-Chia Fong
- L&M Policy Research, Washington, District of Columbia, USA
| | - Julia G Burgdorf
- VNS Health Center for Home Care Policy & Research, New York City, New York, USA
| | - Emily C Franzosa
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- James J. Peters VA Medical Center, Bronx, New York, USA
| | | | | |
Collapse
|
32
|
Setyawati MB, Parsons AJ, Laing B, Lynch A, Habiburahman IL, Izza FN. The family caregiving; A Rogerian concept analysis of Muslim perspective & Islamic sources. Heliyon 2024; 10:e25415. [PMID: 38356493 PMCID: PMC10865263 DOI: 10.1016/j.heliyon.2024.e25415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 12/21/2023] [Accepted: 01/25/2024] [Indexed: 02/16/2024] Open
Abstract
Despite the numerous concepts of caregiving discussed in the literature, there is still no agreed definition and concept of family caregiving from the perspective of Islam. This study aims to comprehensively define family caregiving from Islamic religious and Muslim cultural perspectives. Rodger's evolutionary model was used to generate content by analyzing and redefining concepts. A thorough examination of the relevant literature using Scopus, PubMed, Medline, and CINAHL databases also trusted sources offered a total of 52 articles and 8 books to be reviewed. Our study reveals that family caregiving is viewed as God's gift as important as an essential religious and cultural obligation in Islam, where humans are expected to deliver care for their families although they are unprepared. This can be motivated by aspirations for respect, love, responsibility, and a desire to recompense parents, as well as the belief that by doing so they will be rewarded in the hereafter. The provision of family caregiving leads to positive consequences such as living with hope, gaining rewards and achievement, but at the same time, it also causes devastated life. This research contributes to a new discourse on family caregiving based on Islamic literature which helps in the comprehension of the practices of Muslim communities worldwide.
Collapse
Affiliation(s)
- Martyarini Budi Setyawati
- School of Nursing, Faculty of Health Sciences, Harapan Bangsa University, Banyumas, Central Java, Indonesia
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - A.P John Parsons
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Bobbi Laing
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Andrew Lynch
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | | | - Farah Nuril Izza
- Faculty of Ushuluddin, Adab, and Humanities UIN Prof. K.H. Saifuddin Zuhri Purwokerto Central Java, Indonesia
| |
Collapse
|
33
|
Tian YJA, Felber NA, Pageau F, Schwab DR, Wangmo T. Benefits and barriers associated with the use of smart home health technologies in the care of older persons: a systematic review. BMC Geriatr 2024; 24:152. [PMID: 38355464 PMCID: PMC10865618 DOI: 10.1186/s12877-024-04702-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/11/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Smart home health technologies (SHHTs) have been discussed in the frame of caregiving to enable aging-in-place and independence. A systematic review was conducted in accordance with the PRISMA guidelines to gather the up-to-date knowledge on the benefits and barriers of using SHHTs in the care of older persons from the perspective of older persons and their caregivers. METHODS Ten electronic databases were reviewed for empirical peer-reviewed literature published from 01.01.2000 to 31.12.2021 in English, German, and French reporting on experimental, qualitative, quantitative, and other empirical study designs were included. Included studies contained user-feedback from older persons over 65 years of age or their caregivers (formal and informal). We used an extraction document to collect relevant data from all included studies and applied narrative synthesis to analyze data related to benefits and barriers of SHHTs. RESULTS 163 empirical peer-reviewed articles were included, the majority of those published between 2014 and 2021. Five first-order categories of benefits and five of barriers were found with individual sub-themes. SHHTs could be useful in the care context where continuous monitoring is needed. They improve self-management and independent living of older persons. Barriers currently exist with respect to ease of usability, social acceptance, and cost. CONCLUSIONS SHHTs could be useful in the care context but are not without concerns. Researchers and policy makers can use the information as a starting point to better understand how the roles and outcomes of SHHTs could be improved for the care of older persons, while caregivers of older adults could use our findings to comprehend the scope of SHHTs and to decide when and where such technology could best address their individual family needs. Limitations lie in the possible exclusion of relevant articles published outside the inclusion criteria as well as the fact that due to digital divide, our review represents opinions of those who could and wanted to participate in the included 163 studies. TRIAL REGISTRATION This review has been registered as PROSPERO CRD42021248543. A protocol was completed in March 2021 with the PRISMA-P guidance. We have extended the review period from 2000 to 2020 since the registration of the protocol to 2000-2021.
Collapse
Affiliation(s)
| | | | - Félix Pageau
- Centre d'excellence sur le vieillissement de Québec, VITAM- Research Center on Sustainable Health, Laval University, Quebec City, QC, Canada
- Division of Geriatrics, Department of Medicine, Laval University, Quebec City, QC, Canada
| | - Delphine Roulet Schwab
- School of nursing sciences, La Source, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, 4056, Switzerland
| |
Collapse
|
34
|
Xiao C, Patrician PA, Montgomery AP, Wang Y, Jablonski R, Markaki A. Filial piety and older adult caregiving among Chinese and Chinese-American families in the United States: a concept analysis. BMC Nurs 2024; 23:115. [PMID: 38347512 PMCID: PMC10863110 DOI: 10.1186/s12912-024-01789-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/01/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The culturally sensitive nursing practice has not embedded filial piety as a cultural value and stance pertaining to caregiving among aging Chinese and Chinese-American (CCA) families in the United States, yet it is critical for healthy aging among CCAs. PURPOSE To understand filial piety when caring for aging CCAs and conceptualize an operational definition and framework. METHODS A systematic search was conducted in CINAHL, PubMed, Scopus, and PsycINFO databases. Analysis of the concept of filial piety among CCAs used Walker and Avant's methods. Twenty-six studies were selected in the final full-text analysis. FINDINGS Synthesis of evidence identified four antecedents: (a) filial obligation as a 'cultural gene', (b) sense of altruism, (c) familial solidarity, and (d) societal expectation of 'birth right'. Attributes included familial material and emotional support, obedience, pious reverence, and societal norms. Consequences were related to caregiver burden, psychological and physical well-being, quality of life, and health equity. CONCLUSION Filial piety is an intrinsic desire to support aging parents and an extrinsic desire to adhere to Chinese societal moral tenets. The proposed operational framework "Caregiving for aging CCAs in the United States" merits further study.
Collapse
Affiliation(s)
- Chunhong Xiao
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA.
| | - Patricia A Patrician
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Aoyjai P Montgomery
- University of Alabama at Birmingham School of Public Health, 1665, 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Youhua Wang
- College of State Governance, Southwest University, No. 2 Tianshen Road, Chongqing, 400715, Beibei District, China
| | - Rita Jablonski
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Adelais Markaki
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| |
Collapse
|
35
|
Lee K, Cassidy J, Lee J, Seo CH, Kunz Lomelin A, Shin HW, Grill JD. Examining Utilization of Formal Supports and Related Impacts on Overall Well-Being Among East Asian American Family Caregivers of Persons With Dementia: A Mixed-Methods Study. Gerontologist 2024; 64:gnad086. [PMID: 37394998 DOI: 10.1093/geront/gnad086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Although East Asian American family caregivers are known to underutilize formal support services, there is a lack of evidence regarding the associations of formal service utilization with caregivers' well-being. This study examined the prevalence of different types of home-and community-based formal service utilization among Korean and Chinese American family caregivers of persons with dementia and how utilization of such services was associated with their well-being. We also explored their overall experience in accessing and utilizing formal dementia support services and programs. RESEARCH DESIGN AND METHODS We employed a convergent mixed-methods study design. In a convenience sampling method, we recruited 62 family caregivers. Logistic regression and thematic analysis were utilized to analyze data. RESULTS The results showed in-home services were mostly utilized among family caregivers of these ethnic groups. Out of 9 different support services, those who utilized nutrition programs and case management were more likely to report higher overall well-being. Four themes were developed: (1) awareness of formal support services but uncertainty on how to access them, (2) language barriers imposing additional challenges in accessing formal support services, (3) traveling to access culturally appropriate services, and (4) desire for culturally tailored medical and long-term care services. DISCUSSION AND IMPLICATIONS Findings from this study suggest the importance of case management services to overcome barriers to accessing and utilizing a wide range of formal support services and provision of culturally appropriate food in formal support services to increase East Asian American family caregivers' utilization of long-term care services.
Collapse
Affiliation(s)
- Kathy Lee
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| | - Jessica Cassidy
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| | - Jihui Lee
- Department of Psychiatry, University of Pittsburgh, Pittsburg, Pennsylvania, USA
| | - Chang Hyun Seo
- School of Social Work, University of Nevada, Reno, Reno, Nevada, USA
| | - Alan Kunz Lomelin
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| | - Hye-Won Shin
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, California, USA
- Somang Society, Cypress, California, USA
| | - Joshua D Grill
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, California, USA
| |
Collapse
|
36
|
Reyes AM, Shang Y. Geographic Relocation in Response to Parents' Health Shocks: Who Moves and How Close? J Marriage Fam 2024; 86:49-71. [PMID: 38504764 PMCID: PMC10947064 DOI: 10.1111/jomf.12939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 08/04/2023] [Indexed: 03/21/2024]
Abstract
Objective This article examines how parent-child geographic proximity changes around the onset of parental health shocks in the United States. Differences in the likelihood of moving closer across social groups are also investigated. Background Adult children often care for older parents with health problems, but this requires relatively close proximity. As families are becoming smaller and many adult children live away from their parents, it is unclear how responsive families will be to older adults' health problems. Method We estimate a series of fixed effects and event study models on data from the Health and Retirement Study (2004-2018) to assess changes in parent-child proximity after parents' first onset of cognitive impairment and functional limitations. Results We find robust evidence that parents and children tend to stay close or move closer to each other in response to parent's health declines. Moves occur immediately and in subsequent waves after the onset of health shocks. Reductions in parent-child distance are consistently larger among mother-daughter dyads, dyads without spouses or multiple children, and non-Hispanic white families. Conclusion The geographic availability of adult children to provide care is responsive to parents' needs. After the onset of a serious health condition, most older adults have a spouse or child living close enough to provide care. Parents' and children's lives are dynamically linked, and either or both may relocate to facilitate care.
Collapse
|
37
|
Zhang ZM, Smith-Johnson M, Gorman BK. Who Cares? Unpaid Caregiving by Sexual Identity, Gender, and Partnership Status Among U.S. Adults. Demography 2024; 61:115-140. [PMID: 38206071 DOI: 10.1215/00703370-11145841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Recent scholarship indicates that sexual minority adults have higher caregiving rates than heterosexuals and that women are more likely to be caregivers than men. However, little research has addressed how gender and sexuality intersect in shaping caregiving status. This study uses data from the Behavioral Risk Factor Surveillance System and aggregates a probability-based sample of adults living in 36 U.S. states between 2015 and 2021. We examine who provides care among adult heterosexual, lesbian, gay, and bisexual men and women. Results reveal that women are more likely to be caregivers than men, but only among heterosexuals. We find little variation in caregiving by sexuality among women, but bisexual men are more likely than heterosexual men to be caregivers; the latter result appears to be driven by unpartnered, bisexual men. Lastly, we contextualize caregivers' experiences and reveal selected descriptive differences in patterns of care recipient-caregiver relationships across gender and sexual identity groups. Our findings advance understanding of caregiving and changing family ties in an era of population aging and increasing diversity in sexual identities.
Collapse
Affiliation(s)
- Zhe Meredith Zhang
- Department of Sociology, California State University, Los Angeles, CA, USA
| | | | | |
Collapse
|
38
|
Callahan LF, Samsell B, DiBenedetti D, Frangiosa T, Slota C, Biggar V, Paulsen R, Lappin D, Herring WL, Romano C. Evaluating Elements of the Care Partner Experience in Individuals Who Care for People with Alzheimer's Disease Across the Severity Spectrum. Neurol Ther 2024; 13:53-67. [PMID: 37889399 PMCID: PMC10787717 DOI: 10.1007/s40120-023-00558-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
INTRODUCTION Non-professional care partners play an important and often evolving role in the care of persons living with Alzheimer's disease (PLWAD). We investigated two elements of the care partner experience, namely time and strain incurred by care partners providing care to PLWAD across the severity spectrum. METHODS Data gathered from the Alzheimer's Disease Patient and Caregiver Engagement (AD PACE) What Matters Most (WMM) study series were analyzed to determine how much time care partners spent providing care to PLWAD based on where the care recipients lived. Additionally, quantitative assessments of weekly hours providing care and the strain experienced by care partners were conducted using the UsAgainstAlzheimer's A-LIST Insights Series survey, which included the Modified Caregiver Strain Index (MCSI). Finally, a targeted literature review was conducted to contextualize findings and characterize the existing literature landscape. RESULTS Care partners in the AD PACE WMM studies (n = 139) spent significantly more hours providing care for recipients who lived with someone (mean ± standard deviation [SD], 57.3 ± 44.3 h/week) than for recipients who lived alone (26.0 ± 12.0 h/week) (P = 0.0096) or lived in assisted living/nursing home (23.6 ± 14.4 h/week) (P = 0.0002). In the A-LIST Insights Series survey, care partners provided an overall mean (± SD) 58.1 ± 53.0 h of direct care each week, with caregiving hours increasing with increasing severity of AD/AD-related dementias (AD/ADRD). Additionally, care partners for recipients with mild (n = 14), moderate (n = 111), and severe AD/ADRD (n = 91) had overall mean MCSI scores of 9.0 ± 3.8 (range 2-14), 13.3 ± 4.8 (range 4-23), and 17.5 ± 5.3 (range 4-26), respectively, with higher scores suggesting greater care partner strain. CONCLUSIONS Persons living with AD require increasing levels of care along the spectrum of disease, and even individuals with early disease need care from partners. Early interventions that slow progression of AD and programs that improve family function may have beneficial impact on the experiences of care partners for recipients with mild, moderate, or severe AD.
Collapse
Affiliation(s)
| | - Brian Samsell
- RTI Health Solutions, Research Triangle Park, NC, USA
| | | | | | | | | | | | | | - William L Herring
- RTI Health Solutions, Research Triangle Park, NC, USA
- Karolinska Institute, Stockholm, Sweden
| | - Carla Romano
- RTI Health Solutions, Research Triangle Park, NC, USA.
| |
Collapse
|
39
|
Zueras P, Grundy E. Assessing the impact of caregiving for older parents on caregivers' health: Initial health status and trajectories of physical and mental health among midlife caregivers for parents and parents-in-law in Britain. Soc Sci Med 2024; 342:116537. [PMID: 38181720 DOI: 10.1016/j.socscimed.2023.116537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/20/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024]
Abstract
Assessing the impact of caregiving for older parents on caregivers' health is increasingly important in the context of population changes and curtailment of state provided services. This has been extensively studied but results are inconsistent, possibly reflecting a lack of attention to health-related selection into the caregiver role. We use data from a nationally representative UK longitudinal study to analyse differences in the health of people aged 40-69 at baseline by whether they were 'eligible' to provide parent care (with a living parent/parent-in-law) and by whether they subsequently assumed a caregiver role. We measured initial health status using a latent variable derived from three observer-recorded indicators as well as self-reported health. We analysed trajectories of physical and mental health over a seven-year follow-up for those providing intensive care (20+ hours per week) to a parent or parent-in-law, providers of lesser amounts of care, and non-caregivers. Outcomes were measured using the SF-12 indicators of mental and physical health. RESULTS: showed that those with a living parent or parent-in-law had better health than those lacking these relatives. However, among potential caregivers for a parent or parent-in-law, those assuming intensive caregiving had poorer initial health than non-caregivers or those who became providers of less intensive care. Fixed effects analyses of follow-up data showed that the mental health of intensive caregivers deteriorated. However, the physical health of intensive caregivers with low levels of education improved. RESULTS: show the importance of taking account of whether people are at risk of providing parental care and initial health status when assessing impacts of caregiving on health. They also indicate differential effects of caregiving on health depending on socio-demographic characteristics and reaffirm the need for greater supports for those providing substantial amounts of care to older parents.
Collapse
Affiliation(s)
- Pilar Zueras
- Institute for Social and Economic Research, University of Essex, Wivenhoe Park, CO4 3SQ, UK.
| | - Emily Grundy
- Institute for Social and Economic Research, University of Essex, Wivenhoe Park, CO4 3SQ, UK.
| |
Collapse
|
40
|
Cardwell K, Awadia Z, McKenna O, Venasse M, Hume T, Ludgate J, Freedman M, Finlayson M, Latimer-Cheung A, Pilutti LA, Fakolade A. Physical activity together for MS (PAT-MS): Secondary outcomes of a randomized controlled feasibility trial. Mult Scler Relat Disord 2024; 82:105399. [PMID: 38184911 DOI: 10.1016/j.msard.2023.105399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/04/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Care partners provide essential care to those with multiple sclerosis (MS). Dyadic interventions promoting health behaviours have wide-reaching benefits for individuals with MS and their care partners. However, behavioural interventions to promote physical activity in patient-caregiver dyads have yet to be explored in an MS-specific context. This study examined the secondary outcomes of the "Physical Activity Together for Multiple Sclerosis (PAT-MS)" intervention, including dyadic adjustment, caregiving tasks, caregiver quality of life, coping, and MS impact in MS dyads. METHODS A randomized controlled feasibility trial of the 12-week behavioural PAT-MS intervention. The Dyadic Adjustment Scale, Caregiving Tasks in MS Scale, Caregiver Quality of Life in MS Scale, Coping with MS Caregiving Inventory, and MS Impact Scale measured secondary outcomes of interest. Mixed-model ANOVAs were used to test changes in variables between groups (PAT-MS vs wait-list control) over time. RESULTS 20 participants, including 10 people with MS (51.4 ± 10.1 years old; median patient-determined disease steps (PDDS) score= 4, IQR= 1.25) and 10 care partners (48.5 ± 12.1 years old) were recruited and randomized. There was no statistically significant effect of the intervention on any of the secondary outcomes (p= 0.67-1.00). However, large effect sizes and condition-by-time interaction effects indicated improvement in dyadic adjustment (d= 1.03, ηp2= 0.45), the criticism-coercion coping subscale (d= -0.93, ηp2= 0.49), and caregiving tasks (d= 1.05, ηp2= 0.52), specifically within psycho-emotional (d= 1.47, ηp2= 0.38) and socio-practical (d= 1.10, ηp2 =0.37) sub-domains of caregiving tasks after the PAT-MS intervention compared to the wait-list condition. CONCLUSION While this pilot feasibility study was not powered based on the secondary outcomes herein, our findings indicate improvement in dyadic adjustment and emotional and social caregiving tasks, with reduced reliance on criticism-coercion coping in the PAT-MS group compared to controls following the intervention. Findings indicate that PAT-MS may improve dyadic psychosocial well-being of people with moderate-to-severe MS and their care partners, and this should be examined next in a fully-powered study.
Collapse
Affiliation(s)
- Katherine Cardwell
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Zain Awadia
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Odessa McKenna
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Myriam Venasse
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Taylor Hume
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Julia Ludgate
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Mark Freedman
- Faculty of Medicine, University of Ottawa, Ottawa, Canada; The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston, Ontario K7L 3N6, Canada
| | - Amy Latimer-Cheung
- School of Kinesiology and Health Studies, Queen's University, Kingston, Canada
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada; Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
| | - Afolasade Fakolade
- School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston, Ontario K7L 3N6, Canada.
| |
Collapse
|
41
|
Sun R, Francis LE. Quality of Relationships and Caregiver Burden: A Longitudinal Study of Caregivers for Advanced Cancer Patients. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad165. [PMID: 37889267 PMCID: PMC10809218 DOI: 10.1093/geronb/gbad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVES In a longitudinal design, this study investigates the role of the quality of relationships in the well-being of caregivers for a family member with advanced cancer, specifically, the quality of relations among family members and the caregiver's commitment to caregiving. Following the stress process model, good quality of relations and caregiver's high commitment should be resources mitigating caregiver burden, even though overinvestment in the caregiver role may lead to the opposite outcome. METHODS Data were drawn from a longitudinal study of 336 caregivers of advanced cancer patients in an urban community, who were interviewed shortly after patient diagnosis and again 3 months later. Caregiver burden is measured by 4 subscales (17 items) of the Caregiver Reaction Assessment. We used a random-effect model to investigate the association between caregiver burden and the 2 focused contributing factors-caregiver commitment and family relationship quality-when other covariates were controlled. A fixed-effect model then examines the association between the changes in caregiver burden and related time-varying factors, including caregiver commitment, when family relationship quality was used as a moderator. RESULTS Both the random and fixed-effect models consistently show that a cancer caregiver's positive commitment to the patient reduces caregiver burden, and family relationship quality provides an overall moderating influence that reduces the felt burden. DISCUSSION The quality of relations between the caregiver and patient and with others in the family network is critical in understanding caregiver burden in advanced cancer and should be viewed as part of long-term family dynamics.
Collapse
Affiliation(s)
- Rongjun Sun
- Department of Criminology and Sociology, Cleveland State University, Cleveland, Ohio, USA
| | - Linda E Francis
- Department of Criminology and Sociology, Cleveland State University, Cleveland, Ohio, USA
| |
Collapse
|
42
|
Aggarwal B, Benasi G, Makarem N, Mayat Z, Byun S, Liao M, Giardina EG. Psychosocial factors are associated with sleep disturbances and evening chronotype among women: A brief report from the American Heart Association Go Red for Women Strategically Focused Research Network. Sleep Health 2024; 10:65-68. [PMID: 38007300 PMCID: PMC10922278 DOI: 10.1016/j.sleh.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVES To evaluate associations between psychosocial factors and sleep characteristics commonly linked to cardiovascular disease risk among racially/ethnically diverse women. METHODS Women from the AHA Go Red for Women cohort (N = 506, 61% racial/ethnic minority, 37 ± 16years) were assessed using self-reported questionnaires. Logistic regression models were adjusted for age, race, ethnicity, education, and insurance. RESULTS Women with depression had ∼3-fold higher odds of short sleep (95%CI=1.69-4.61), 2-fold higher odds of poor sleep quality and obstructive sleep apnea risk (95%CI=1.42-3.70 and 1.34-4.24), 4-fold higher odds of insomnia (95%CI=2.42-6.59), and greater likelihood of having an evening chronotype (OR:2.62, 95%CI=1.41-4.89). Low social support was associated with insomnia (OR:1.79, 95%CI=1.18-2.71) and evening chronotype (OR:2.38, 95%CI=1.35-4.19). Caregiving was associated with short sleep (OR:1.73, 95%CI=1.08-2.77) and obstructive sleep apnea risk (OR:2.46, 95%CI=1.43-4.22). CONCLUSIONS Depression, caregiver strain, and low social support are significantly associated with poor sleep and evening chronotype, highlighting a potential mechanism linking these psychosocial factors to cardiovascular disease risk.
Collapse
Affiliation(s)
- Brooke Aggarwal
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA; Sleep Center of Excellence, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
| | - Giada Benasi
- Sleep Center of Excellence, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA; Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Nour Makarem
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Zara Mayat
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Stephanie Byun
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Ming Liao
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Elsa-Grace Giardina
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| |
Collapse
|
43
|
Goh ZZS, Ho MHR, Ng KYY, Chia JMX, Ishak NDB, Shwe TT, Chua ZY, Ngeow JYY, Griva K. Using the Actor-Partner Interdependence Model to explore the psychological impact of COVID-19 on anxiety in dyads of patients with cancer and caregivers. Int J Behav Med 2024; 31:19-30. [PMID: 36788172 PMCID: PMC9928140 DOI: 10.1007/s12529-023-10154-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Delineating the compound psychological effect of the pandemic on cancer care, and the interdependency across cancer patient-caregiver dyads have yet to be explored. This study examines the levels of psychological impact of COVID-19 on patient-caregiver dyads anxiety, and the interdependent associations between their COVID-19 and cancer concerns, and risk perceptions. METHOD There were 352 patients and caregivers (patient-caregiver dyads, N = 176) included in this study (43.2% spousal dyads). Generalized Anxiety Disorder-7 and questionnaires regarding risk perception, perceived confidence in healthcare system, COVID-19, and cancer-related concerns were administered. Actor-Partner Interdependence Model (APIM) analyses were used to determine the interdependent effects. Indirect effects were tested using mediation pathway analyses. RESULTS Patients reported significantly higher levels of risk perceptions and anxiety than their caregivers (p < 0.01). Anxiety rates (GAD-7 ≥ 10) were also significantly higher (26.7% vs 18.2%, p < 0.01). Dyads' anxiety, "general COVID-19 concerns," "cancer-related concerns," and risk perceptions were correlated (ps < 0.01). APIM showed only actor effects of general COVID-19 concerns, cancer-related COVID-19 concerns, and risk perceptions on anxiety (βs = 0.19-0.53, ps < 0.01). No partner effects were observed. Similar results were found in the composite APIM. Indirect effects of the patient/caregiver's variables on their partner's anxiety were observed in the mediation analyses. CONCLUSION Concerns about COVID-19 and cancer care could be indirectly associated in patient-caregiver dyads and need to be proactively addressed. As pandemic evolves into endemicity, engagement with patients and caregivers should strive to be sensitive to their differential needs and messages should be tailored to the informational needs of each.
Collapse
Affiliation(s)
- Zack Zhong Sheng Goh
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Moon-ho R. Ho
- School of Social Sciences, Nanyang Technological University Singapore, Singapore, Singapore
| | - Kennedy Yao Yi Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Jace Ming Xuan Chia
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Nur Diana Binte Ishak
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Than Than Shwe
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Zi Yang Chua
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Joanne Yuen Yie Ngeow
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore, 308232 Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore, 308232 Singapore
| |
Collapse
|
44
|
Freedman VA, Agree EM, Seltzer JA, Birditt KS, Fingerman KL, Friedman EM, Lin IF, Margolis R, Park SS, Patterson SE, Polenick CA, Reczek R, Reyes AM, Truskinovsky Y, Wiemers EE, Wu H, Wolf DA, Wolff JL, Zarit SH. The Changing Demography of Late-Life Family Caregiving: A Research Agenda to Understand Future Care Networks for an Aging U.S. Population. Gerontologist 2024; 64:gnad036. [PMID: 36999951 PMCID: PMC10825830 DOI: 10.1093/geront/gnad036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Indexed: 04/01/2023] Open
Abstract
Repeated claims that a dwindling supply of potential caregivers is creating a crisis in care for the U.S. aging population have not been well-grounded in empirical research. Concerns about the supply of family care do not adequately recognize factors that may modify the availability and willingness of family and friends to provide care to older persons in need of assistance or the increasing heterogeneity of the older population. In this paper, we set forth a framework that places family caregiving in the context of older adults' care needs, the alternatives available to them, and the outcomes of that care. We focus on care networks, rather than individuals, and discuss the demographic and social changes that may alter the formation of care networks in the future. Last, we identify research areas to prioritize in order to better support planning efforts to care for the aging U.S. population.
Collapse
Affiliation(s)
- Vicki A Freedman
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily M Agree
- Department of Sociology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Judith A Seltzer
- Department of Sociology, University of California, Los Angeles, Los Angeles, California, USA
| | - Kira S Birditt
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Karen L Fingerman
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Esther M Friedman
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - I-Fen Lin
- Department of Sociology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Rachel Margolis
- Department of Sociology, University of Western Ontario, London, Ontario, Canada
| | - Sung S Park
- Office of Population Research, Princeton University, Princeton, New Jersey, USA
| | - Sarah E Patterson
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Rin Reczek
- Department of Sociology, Ohio State University, Columbus, Ohio, USA
| | - Adriana M Reyes
- Brooks School of Public Policy and Department of Sociology, Cornell University, Ithaca, New York, USA
| | | | - Emily E Wiemers
- Department of Public Administration and International Affairs, Syracuse University, Syracuse, New York, USA
| | - Huijing Wu
- Department of Sociology, University of Western Ontario, London, Ontario, Canada
| | - Douglas A Wolf
- Aging Studies Institute, Syracuse University, Syracuse, New York, USA
| | - Jennifer L Wolff
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Steven H Zarit
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania, USA
| |
Collapse
|
45
|
Manalel JA, Sumrall S, Davidson H, Grewal M, Granovetter MA, Koehly LM. Stress, coping, and positive aspects of caregiving among caregivers of children with rare disease. Psychol Health 2024; 39:216-232. [PMID: 35620936 PMCID: PMC9701241 DOI: 10.1080/08870446.2022.2057494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 02/22/2022] [Accepted: 03/20/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Caregivers of children with rare diseases often consider caregiving to be a rewarding experience, despite high levels of burden. The present study examined associations between caregiver stress and positive aspects of caregiving (PAC); investigated associations between interpersonal coping strategies and PAC; and determined whether coping strategies moderated associations between stressors and PAC. DESIGN Survey data came from a study on caregivers across different caregiving conditions, including caregivers of children diagnosed with inherited metabolic conditions (n = 167), undiagnosed diseases (n = 23), and caregivers of typically-developing children (n = 74). MAIN OUTCOME MEASURES Positive Aspects of Caregiving (PAC) scale. RESULTS Results from generalized linear models indicated that perceived burden was not associated with PAC. Venting was negatively associated with PAC (b= -0.09, p=.03), whereas emotional support was associated with increased PAC for caregivers of children with undiagnosed conditions (b = 0.15, p=.02). Care needs were associated with greater PAC among caregivers engaged in high levels of emotional support coping (b = 0.10, p=.01) and venting (b = 0.09, p=.03). CONCLUSION These findings illuminate important differences in PAC based on the caregiving condition, and aspects of the caregiver stress process model that might be universal to caregivers. Results inform stress process theory and highlight the potential of support-based interventions for promoting PAC. Supplemental data for this article is available online at.
Collapse
Affiliation(s)
- Jasmine A Manalel
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
- Brookdale Center for Healthy Aging, Hunter College, City University of New York, New York, NY, USA
| | - Sydney Sumrall
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Hannah Davidson
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Meghan Grewal
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | | | - Laura M Koehly
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
46
|
Bahrami M, Nasiri A. Behind the scenes of caregiving in patients with advanced cancer: A qualitative study on family caregivers. Asia Pac J Oncol Nurs 2024; 11:100330. [PMID: 38179137 PMCID: PMC10764250 DOI: 10.1016/j.apjon.2023.100330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/23/2023] [Indexed: 01/06/2024] Open
Abstract
Objective Family caregivers may have concerns that they do not want to disclose to others. This study aims to delve into the concealed facets of care provided by family caregivers to patients with advanced cancer. Methods A qualitative approach was conducted in Iran from June 2022 to February 2023. Face-to-face, in-depth semi-structured interviews were carried out with 16 Iranian family caregivers of patients with advanced cancer, employing purposive sampling. The gathered data were analyzed using conventional content analysis, and Lincoln and Guba's criteria for rigor were applied to ensure the study's trustworthiness. Results The analysis of the data resulted in the identification of three main themes with nine subthemes. The key themes derived from the experiences of family caregivers encompassed (1) chaotic mentalities, (2) troubling interdependence, and (3) desperational emotions. Conclusions Caregivers of patients with advanced cancer commonly experience a highly fragile psychological state and are profoundly impacted by their concerns for the patient. Healthcare systems should prioritize ensuring that caregivers receive sufficient support and care.
Collapse
Affiliation(s)
- Mahnaz Bahrami
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Ahmad Nasiri
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
| |
Collapse
|
47
|
Perepezko K, Shaffer K, Beach S, Rolle N, Fields B. Effects of Caregiver Sleep Disturbances on Relationship Quality With Their Care Recipient. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad137. [PMID: 37738509 DOI: 10.1093/geronb/gbad137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVES Sleep problems are highly prevalent and disruptive for caregivers. Although the connection between caregivers' sleep and outcomes like caregiver burden and quality of life is well established, the potential influence of caregivers' sleep on their reported relationship quality with the care recipient is not known. The current study sought to address this gap. METHODS We analyzed data from the 2017 National Health and Aging Trends Study and linked it with data from the 2017 National Study of Caregiving. Our dependent variable was caregiver-reported relationship quality, and our predictor variable of interest was caregiver sleep problems. We also included several covariates related to the caregiver and care recipient. We used a generalized linear model to examine the relationship between caregiver sleep problems and relationship quality, controlling for other potentially influential factors. RESULTS Sleep problems were significantly related to relationship quality. Compared to caregivers who reported no sleep problems, those who reported at least one sleep problem (β: -0.23, 95% CI: -0.46 to -0.01) had lower relationship quality with the care recipient. Other factors that remained related to relationship quality in the generalized linear model were negative aspects of caregiving, emotional difficulties, caregiver race, relationship type, care recipient depressive symptoms, and care recipient sex. DISCUSSION Sleep problems are influential health behaviors that are related to relationship quality for caregivers. Therefore, it is critical that sleep is more systematically assessed and addressed in caregiving populations.
Collapse
Affiliation(s)
- Kate Perepezko
- National Center on Family Support, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kelly Shaffer
- Center for Behavioral Health and Technology, University of Virginia, Charlottesville, Virginia, USA
| | - Scott Beach
- National Center on Family Support, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Natalie Rolle
- Center for Community Partnerships, Colorado State University, Fort Collins, Colorado, USA
| | - Beth Fields
- National Center on Family Support, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| |
Collapse
|
48
|
Bayram E, Liu H, Luo S, Di Luca DG, Skipworth M, Damron Solomon L, Dahodwala N, Litvan I. Ethnoracial differences for caregiving burden in Parkinson's disease. Parkinsonism Relat Disord 2024; 118:105927. [PMID: 37952272 PMCID: PMC10911683 DOI: 10.1016/j.parkreldis.2023.105927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Caregivers play an important role in Parkinson's disease (PD) treatment, especially as the disease progresses. As the symptom profile and needs of people with PD (PwP) differ across ethnoracial groups, whether caregiving needs also differ for different ethnoracial groups should be investigated. METHODS Data were obtained from the Parkinson's Foundation funded Parkinson's Outcomes Project for PwP identifying as Hispanic (n = 495), non-Hispanic Asian (n = 170), non-Hispanic Black (n = 162), or non-Hispanic White (n = 7687). Cross-sectional and longitudinal total Multidimensional Caregiver Strain Index (MCSI) and domain-specific scores for caregiving burden were compared across the ethnoracial groups. Effect of demographics and clinical variables, interaction of these variables with ethnoracial groups for caregiver burden was assessed. RESULTS Care partners of PwP identifying as non-Hispanic Asian experienced the most burden. PwP identifying as non-Hispanic White were oldest, yet their care partners experienced the least burden. Care partners of PwP identifying as non-Hispanic Asian experienced more burden in physical and social domains, care partners of PwP identifying as Hispanic experienced more burden in financial and elder demanding/manipulative domains. Over time, burden increased similarly across the ethnoracial groups. Effect of frequency of falls, hospital admission, neuropsychiatric disorder and social support on burden over time differed across the groups. CONCLUSION PwP from different ethnoracial groups can experience different levels of caregiving burden. Predictors for caregiving burden, such as social support and falls can have different impacts based on ethnicity and race. Caregiver needs should also be assessed and culturally competent support should be provided to benefit all affected by PD.
Collapse
Affiliation(s)
- Ece Bayram
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
| | - Hongliang Liu
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Sheng Luo
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.
| | - Daniel G Di Luca
- Department of Neurology, Washington University in St. Louis, MO, USA.
| | - Michael Skipworth
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
| | - Lisa Damron Solomon
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
| | - Nabila Dahodwala
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Irene Litvan
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
| |
Collapse
|
49
|
Abstract
OBJECTIVES The care of individuals with Alzheimer's disease (AD) relies on family caregivers (FCs) who face increasing demands. This study aimed to identify trajectories of depressive symptoms in FCs. METHODS 226 FCs and individuals with AD were followed up for 5 years as a part of the ALSOVA study. Depressive symptoms in FCs were measured with the Beck Depression Inventory from the time of the AD diagnosis to the 5-year follow-up. We compared the trajectory of groups regarding age, education, and sex of both FC distress and AD symptoms. RESULTS We identified three trajectories of FC depressive symptoms throughout follow-up: (1) declining (7.5% of FCs), (2) minor (59.7% of FCs), and (3) increased (32.7% of FCs). These groups exhibited differences in demographic variables, FC distress, and individuals with AD neuropsychiatric symptoms. CONCLUSIONS The present study showed that FC depressive symptoms existed, and one-third of caregivers experienced increasing depressive symptoms over five years. CLINICAL IMPLICATIONS Family caregivers' health should be followed in clinical practice, and those at risk of depression could be recognized early in caregiving.
Collapse
Affiliation(s)
- Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Anne M Koivisto
- NeuroCentre, Neurology, Kuopio University Hospital, Kuopio, Finland
- Department of Neurology, School of Medicine, Institute of Clinical Medicine, Kuopio, Finland
- Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland
- Department of Neurosciences, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tuomas Selander
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Toni Saari
- NeuroCentre, Neurology, Kuopio University Hospital, Kuopio, Finland
- Department of Neurology, School of Medicine, Institute of Clinical Medicine, Kuopio, Finland
| | - Ilona Hallikainen
- Department of Neurology, School of Medicine, Institute of Clinical Medicine, Kuopio, Finland
| |
Collapse
|
50
|
Levenson RW. Two's company: Biobehavioral research with dyads. Biol Psychol 2024; 185:108719. [PMID: 37939868 DOI: 10.1016/j.biopsycho.2023.108719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/28/2023] [Accepted: 11/03/2023] [Indexed: 11/10/2023]
Abstract
The development of paradigms for studying dyadic interaction in the laboratory and methods and analytics for dealing with dyadic data is described. These are illustrated with research findings from the author and others with particular focus on dyadic measures of linkage or synchrony in physiology, expressive behavior, and subjective affective experience.
Collapse
|